From the Guidelines
Quetiapine is likely effective for a 17-year-old female with bipolar depression, although the evidence is based on adult studies and limited data in adolescents.
Efficacy of Quetiapine
- The FDA has approved quetiapine for acute mania in adults, but not specifically for bipolar depression in adolescents 1.
- A double-blind, controlled trial found that quetiapine plus valproate worked better than valproate alone for adolescent mania, suggesting some efficacy in this age group 1.
- Open-label trials and retrospective chart reviews also support the effectiveness of quetiapine for pediatric bipolar disorder, including a study by Marchand et al. (2004) 1.
Important Considerations
- Quetiapine should be used with caution in adolescents, as the evidence is limited and weight gain is a concern, especially in youths 1.
- The dose range for quetiapine in adolescents is not well established, but it is likely similar to the dose range used in adults.
- Quetiapine may be used in combination with other mood stabilizers, such as valproate, to enhance efficacy 1.
Clinical Decision Making
- In clinical practice, quetiapine may be considered as an adjunctive treatment for bipolar depression in adolescents, particularly when other treatments have failed or are not tolerated.
- However, careful monitoring of side effects, including weight gain, is essential, and the patient's response to treatment should be regularly assessed 1.
The FDA Drug Labels for quetiapine (PO) do not address this question.
From the Research
Efficacy of Quetiapine for Bipolar Depression in a 17-Year-Old Female
- The efficacy of quetiapine for bipolar depression in adolescents has been investigated in several studies 2, 3.
- A study published in the Journal of Child and Adolescent Psychopharmacology found that quetiapine extended-release did not demonstrate efficacy relative to placebo in an 8-week study of pediatric bipolar depression 2.
- However, a systematic review and meta-analysis published in Drug Design, Development and Therapy found that quetiapine was effective in the treatment of acute bipolar depression, with a significant improvement in depression scores compared to placebo 3.
- Other studies have also found quetiapine to be effective in the treatment of bipolar depression, with rapid and sustained improvements in depressive and anxiety symptoms, as well as improvements in health-related quality of life 4, 5, 6.
Safety and Tolerability
- The safety profile of quetiapine in pediatric patients with bipolar depression has been found to be broadly consistent with the profile reported previously in adult studies and pediatric studies of quetiapine immediate-release 2.
- Common adverse effects of quetiapine include extrapyramidal side effects, sedation, somnolence, dizziness, fatigue, constipation, dry mouth, increased appetite, and weight gain 3.
- Quetiapine has also been found to be associated with potentially clinically significant elevations in clinical chemistry values, including triglycerides and thyroid stimulating hormone 2.